Cognitive frailty and drug burden in near-centenarians (95 years and older adults)

Abstract

Purpose: Cognitive frailty is an emerging concept in geriatric medicine, defined by the coexistence of cognitive impairment and physical frailty without dementia. We planned to investigate the relationship between cognitive frailty and drug burden in individuals aged 95 years and older. Materials and Methods: This retrospective cross-sectional study included 193 individuals aged ≥95 years receiving care at geriatric outpatient clinics or residential facilities in Turkey. Data on cognitive status, comorbidities, and regular medication use were obtained from medical records. Cognitive frailty was identified based on documented as cooccurrence of physical frailty and cognitive impairment. Results: Among the participants, 45.1% were identified as cognitively frail. The cognitive frailty group exhibited a significantly lower mean MMSE score (19.8 ± 3.7) in comparison to the control group (24.7 ± 3.1, p < 0.001). The mean number of medications was higher among cognitive frailty participants (6.3 ± 2.1) than those without cognitive frailty (4.1 ± 1.8, p < 0.01). After adjusting for all variables, increased age (OR: 1.11, 95% CI: 1.03–1.20, p = 0.006), higher number of comorbidities (OR: 1.23, 95% CI: 1.05–1.45, p = 0.014), and greater number of medications (OR: 1.36, 95% CI: 1.14–1.64, p = 0.001) were significantly associated with increased cognitive frailty. Conclusion: Cognitive frailty is independently associated with a higher drug burden in individuals aged 95 and older. Integrating cognitive and frailty assessments into routine geriatric evaluations may help mitigate the risks of polypharmacy in this vulnerable population.